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EGD with APC for AVM's

Lisa d Posted Tue 01st of November, 2011 17:40:09 PM

What's the code for EGD with APC for AVM's... I am choosing the 43255. Insurance doesn't like the code when I'm billing it with the 43239. It has nothing to do with bleeding.

SuperCoder Answered Wed 02nd of November, 2011 12:14:21 PM

If there is no bleeding control in the procedure, then use only 43239.

Tanya Answered Wed 02nd of November, 2011 19:47:25 PM

They don't like it because you need modifier -59 to indicate the bleeding is not from the biopsy site. If it is, then it's included in 43239. If the AVM's are not bleeding, use 43258. There is no CCI conflict with 43239 & 43258.

Catherine Answered Sat 12th of November, 2011 13:03:43 PM

Bill the 43255 1st with mod 59, and then 43239 second if appropriate of course.

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